PubMed · 5647918
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Y H Zimberg, C G Lynch. 1968. Controlled operative atelectasis.. https://doi.org/10.1016/s0003-4975(10)66350-3
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PURPOSE: Low-vacuum scanning electron microscopy (Ivac SEM) was used to characterize the appearance of metal particles released from stressed and unstressed Champy miniplates placed in dogs and to study the relationship of the debris to the surrounding tissues. MATERIALS AND METHODS: Under general endotracheal anesthesia, two Champy miniplates (titanium or stainless steel) were placed on the frontal bone in an animal model. One miniplate was bent to fit the curvature of the frontal bone (unstressed) and another miniplate of the same material was bent in a curve until the midpoint was raised 3 mm above the ends. The latter miniplate adapted to the skull curvature under tension during screw insertion (stressed). The miniplates and surrounding tissues were retrieved after intervals of 4, 12, and 24 weeks. Decalcified sections were prepared and examined by light microscopy and Ivac SEM. RESULTS: Under Ivac SEM examination, the titanium particles had a smooth, polygonal outline. Stainless steel particles were typically spherical, with numerous small projections on the surface. Most particles were 1 to 10 microns in diameter. The tissue response to the particles was variable; some particles were covered by fibrous connective tissue or enclosed by bone, and others were intracellular. CONCLUSIONS: The metal particles released from stressed or unstressed Champy miniplates were similar, and this was related to their source of origin and duration within the tissues. The tissue response to the particles appeared to depend on their location.
The choice of sedation for emergency intubation remains controversial. This lack of consensus has led to various sedation protocols used in French prehospital care setting. A review of data from the literature suggests that the association etomidate-suxamethonium is probable the best choice for rapid sequence intubations in the prehospital setting. Its benefits include protection against myocardial and cerebral ischaemia, decreased risk of pulmonary aspiration, and a stable haemodynamic profile. Randomized studies are needed to substantiate the advantages of the association etomidate-suxamethonium for rapid sequences intubation in the prehospital setting.
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